For those of you who do not know, hydrocephalus is a condition where the child produces more cerebral spinal fluid than is normal. If this is left unchecked it can cause the head of the baby to expand. The bones of the skull are not fused together at such a young age and thus the head had room to expand. If this continues it can cause severe brain and spinal damage. I have studied this condition in great length during my courses, but the condition is quite rare in the US. So I felt very privileged to be present for one of these surgeries.
In this picture they are doing an irrigation surgery. I don't really know what this is called in the US, but it is done when the child has blood mixed I'm with the CSF in the brain cavity. So they open up the skull and drain the bloody cfs, then replace it with saline until the fluid is clear. The surgeon was amazing. He was finished in 30 minutes and it can easily take 2 hours. Their facility may not look as professional as surgery rooms in the states, but that surgeon is world class!
In between the two surgeries, Sam and I went down to the ICCU to see the children who had been operated on earlier that day. Each one was beautiful and also heart breaking. I hope you understand that I am not happy about the sorrow that these tiny babies have seen, but I am glad that I had a chance to be a part of their lives even if it was just for a few minutes.
The child above is being monitored until his vitals normalize. As you can tell he has severe hydrocephalus. In a normal child CFS is used to keep the brain tissue moist as well as the base of the spinal chord protected. Once used it is reabsorbed into the blood stream, but in this youngster the fluid is not reabsorbed. He just keeps producing CFS even though the old fluid still lingers. He had a shunt put in a few days ago, but it hasn't done enough to reduce the pressure on his brain. A shunt is a common treatment option for hydrocephalus. It is a plastic tube that starts in a ventricle in the brain and then diverts the CSF to another part of the body where is can be reabsorbed. In some patients this is enough, but in this little guy it is not working. It is heart breaking to see, but the expansion of the skull is actually saving his life. When hydrocephalus develops in a child this young operations can be completed before the brain is damaged. If hydrocephalus develops in an adult or older child the skull cannot expand therefore the condition might become fatal if it is not treated quickly. Ta little guy looks pretty bad, but the nurses in the ICCU were hopeful that he would eventually pull out okay.
The next little guy is in a sad shape, so just be aware.
He has quite a lot of health concerns as you can see. He has hydrocephalus, a cleft lip, and his right eye did not develop properly. The last two are not life threatening so they are only working on hydrocephalus for now. Although the cleft lip and eye are gruesome, he could live with those easily for some time. The nurse said his chances are pretty slim, but they are going to do all they can. The nurse, Ezra, let us help dress the infection on the eye. With tender hands Sam and I helped to clean and rebandage his eye. He was a trooper through the whole thing! He barely whined at all, which is pretty impressive. I loved holding his tiny tiny hands!
After helpjg this fellow, Ezra asked me to go and comfort one of the mothers. She has lost all hope of her child recovering. You can imagine that it would be hard to keep a positive attitude through something like this, but many of the mothers strengthen each other and trust in a higher power. This wonderful woman, however, was terrified that her son would not make it. Ezra said that he probably wouldn't, but that they must help support each parent and keep them hopeful. I think my favorite moment of the whole day was watching Ezra comfort this mother. She was tearing up as we walked around the unit, so Ezra took some time to talk with her and try to give her hope once more. It was beautiful to witness the love that he has for these children and their families! Ezra told me that they do what they can for the parents, but more help is always appreciated. He suggested that I walk around and be a counselor. I didn't get to speak with her, because we had to go to the second surgery. I would like to go back and work with those mothers to help them deal with the massive amounts of stress with which they are dealing.
This is Ezra with Sam and again with me. I wanted you to see Sam so you have a face to the name.
Ezra was not very keen to smile, but I won him over in the end! He offered me a job in the ICCU anytime I wanted to move back to Uganda!!!! ;)
It was a wonderful day! We met some wonderful people and got a better idea of health care in Uganda!
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